Table 4 Headaches and their characteristics in cranial and vascular disorders. (The table belongs to the chapter “Migraine and epilepsy mimics in neurovascular disorders”)
From: Migraine - a borderland disease to epilepsy: near it but not of it
Vascular disorder | Headache characteristics | Seizures |
|---|---|---|
Ischaemic stroke | Moderate, diffuse, unspecific, posterior circulation | 6–8% Possible |
TIA | Neurological deficits can mimic migraine aura, headache simultaneous to deficit | Limb-shaking (non-epileptic) |
Non-traumatic intracerebral haemorrhage/SAH/ASDH | Sudden onset/thunderclap headache | Possible |
Unruptured aneurysm | Can mimic migraine and other primary headaches, worsening while growing | Possible |
AVM | Uncommon, it can present as migraine with aura | Usual |
DAVF | Diffuse headache, worse in the morning, coughing and bending over, associated with pulsatile tinnitus +/- ophthalmoplegia | Possible |
Cavernous angioma | Usually infrequent, unspecific, and secondary to cerebral hemorrhage, and/or seizures | Usual |
Sturge-Webber syndrome | Migraine-like headache | Usual |
GCA | New persistent headache > 60 years old, Amaurosis fugax, jaw claudication | Unlikely |
PACNS or SACNS | Unspecified headache | Usual |
Cervical, vertebral or intracranial dissection | Unilateral pain, without typical migraine features | Unlikely |
Post-endarterectomy, angioplasty, or stenting | Mostly diffuse and mild to moderate, can be unilateral without typical migraine features | Possible |
CVT | Intracranial hypertension headache | Possible |
Cranial venous stenting | Ipsilateral to stenting | Unlikely |
Angiography/endarterial procedure | Can cause triggered migraine | Unlikely |
RCVS | Sudden/thunderclap headache | Yes |
CADASIL | Migraine with aura | Possible |
MELAS | Migraine-like headache | Usual |
MMA | Migraine-like headache | Possible |
CAA | Migraine-like, aura | Possible |
RVCLSM | Migraine-like headache | Yes |
Pituitary apoplexy | Sudden headache, visual loss | Unusual |